Clinical Epidemiology and Global Health最新文献

{"title":"Determinants of medication knowledge using DFIT% score in indian geriatric population: A cross-sectional study","authors":"Sneha Gowthaman ,&nbsp;Mohammed Fayaz Sadiqbasha ,&nbsp;Padma Priya Rangachapam Mani ,&nbsp;Varun Sundaramoorthy ,&nbsp;Dhandapani Chidambaram","doi":"10.1016/j.cegh.2025.102232","DOIUrl":"10.1016/j.cegh.2025.102232","url":null,"abstract":"<div><h3>Problem</h3><div>Assessing medication knowledge in older adults is critical for managing chronic diseases, yet existing tools are often impractical or lack specificity. This study evaluates a composite score (DFIT%) assessing knowledge of Dose, Frequency, Indication, and Time of administration.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 202 geriatric patients (≥65 years) to determine the association between DFIT% and patient characteristics were analyzed using bivariate tests and logistic regression.</div></div><div><h3>Results</h3><div>DFIT% was strongly associated with cognitive status; patients without impairment scored significantly higher (67.1 % vs 43.5 %, p &lt; 0.0001). A higher DFIT% score was associated with lower odds of polypharmacy (OR = 0.984, p = 0.018) and recent medication changes (OR = 0.986, p = 0.043). Ability to read English was also statistically associated with (OR = 1.020, p = 0.041) DFIT% score. No significant associations were found with hospitalization or disease duration.</div></div><div><h3>Conclusion</h3><div>The DFIT% score is a practical tool that identifies specific medication knowledge deficits, which are significant to cognitive function and treatment complexity. It can help target interventions to improve medication safety in geriatric populations.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102232"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effectiveness of pilot hypertension program on hypertension prevention, treatment and control: Insights from Amhara region","authors":"Abiyie Demelash Gashe ,&nbsp;Dawit Zenebe ,&nbsp;Aman Yesuf Endries","doi":"10.1016/j.cegh.2025.102269","DOIUrl":"10.1016/j.cegh.2025.102269","url":null,"abstract":"<div><h3>Problems considered</h3><div>To improve hypertension control, Ethiopia has been piloting a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained. This study aimed to determine the effectiveness of a pilot hypertension program in hypertension prevention, treatment and control in the Amhara region of Ethiopia.</div></div><div><h3>Methods</h3><div>A parallel evaluation design guided by the CDC's Framework for Public Health Program Evaluation was conducted at four pilot and four non-pilot health facilities in Ethiopia's Amhara region. Data were collected using a checklist and a structured questionnaire. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95 % confidence intervals, and p &lt; 0.05.</div></div><div><h3>Results</h3><div>Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91 %, 95 % CI: 87.8–93.5 %) than in non-pilot facilities (74.4 %, 95 % CI: 71.2–79.7 %). Hypertension detection rates were also significantly higher in pilot facilities (19.9 %, 95 % CI: 16.2–24.0 %) compared to non-pilot facilities (14.9 %, 95 % CI: 11.7–18.6 %). BP control was achieved in 51.8 % of patients in pilot and 42.4 % in non-pilot facilities (χ² = 10.823; p &lt; 0.001). The mean performance across the three domains was higher in pilot facilities (76.1 %) compared to non-pilot facilities (51.2 %) (t = 2.125; p = 0.042)</div></div><div><h3>Conclusion</h3><div>The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, evidence base treatment and integration into community level care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102269"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresentation of Africa in HIV cure research: A systematic review of the literature from 2010 to 2022","authors":"Evelyn Y. Bonney ,&nbsp;James O. Aboagye ,&nbsp;Helena Lamptey ,&nbsp;Anthony T. Boateng ,&nbsp;Christopher Z-Yen Abana ,&nbsp;Bernard A. Logonia ,&nbsp;Angela Hardi ,&nbsp;George B. Kyei","doi":"10.1016/j.cegh.2025.102250","DOIUrl":"10.1016/j.cegh.2025.102250","url":null,"abstract":"<div><h3>Problem considered</h3><div>Over the past decade, there has been a significant increase in research aimed at finding a cure or achieving long-term remission for HIV. However, the extent to which this research includes Africa—the continent with the highest HIV burden—remains unclear. To address this, we conducted a systematic review of the literature to assess Africa's contributions to HIV cure research.</div></div><div><h3>Methods</h3><div>We reviewed original HIV cure-related research published from January 1, 2010, to December 31, 2022, in <span><span>Embase.com</span><svg><path></path></svg></span> and Web of Science. Our search terms, ‘HIV cure(s)’ and ‘research,’ along with their synonyms like HIV latency, persistence, and reactivation, covered all languages and geographic locations. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</div></div><div><h3>Results</h3><div>Of 1077 studies reviewed, 614 (57 %) were performed in North America, followed by Europe (24.3 %), Asia (17.2 %), and Australia 5.2 %). Africa contributed only 31 studies (2.9 %). Of the 31 African studies, Southern Africa accounted for 67.7 %, followed by Eastern Africa (19.4 %) and Western Africa (12.9 %). No cure-related studies were performed in Northern and Central African institutions. African contributions across the different types of studies were 18 (3.7 %) for ex vivo, 8 (10.7 %) for social science and epidemiological, 3 (3.3 %) for clinical trials, 4 (0.8 %) for basic science, and zero for animal studies. The NIH funded the majority of all cure-related studies.</div></div><div><h3>Conclusions</h3><div>This systematic review shows that African patients and scientists are contributing little to HIV cure research, and urgent measures are needed to remedy the disparity.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102250"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the hidden burden of malnutrition in tuberculosis: A multifaceted evaluation using malnutrition universal screening tool and patient-generated subjective global assessment","authors":"Priyanka Guha ,&nbsp;Meenakshi Abbagouni ,&nbsp;Maturu Ashok ,&nbsp;Rajat Kumar Mishra ,&nbsp;Tukaram Kendre ,&nbsp;Gulshan Singh Rana ,&nbsp;Abhik Sen ,&nbsp;Krishna Pandey ,&nbsp;Sameer Dhingra","doi":"10.1016/j.cegh.2025.102253","DOIUrl":"10.1016/j.cegh.2025.102253","url":null,"abstract":"<div><h3>Problem considered</h3><div>Tuberculosis (TB) remains a significant public health burden, especially in resource-limited countries. Malnutrition is a significant concern among TB patients, exacerbating symptoms and impeding recovery. Despite this, standardised nutritional screening remains underutilised in TB care programs. Accurate and routine nutritional assessment is essential to guide timely interventions and improve treatment outcomes among TB patients. This study aimed to assess malnutrition risk in TB patients using MUST and PG-SGA, evaluate disagreement between screening tools, and determine the limitations of Body Mass Index (BMI) based assessments.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among 194 adult TB patients receiving anti-TB therapy in Bihar, India. Nutritional risk was evaluated using MUST and PG-SGA, along with demographic, clinical, and anthropometric data. Statistical analyses included ANOVA, Bonferroni post hoc tests, chi-square tests, and Cohen's kappa to assess agreement between tools.</div></div><div><h3>Results</h3><div>The study revealed a high prevalence of malnutrition risk, with MUST detecting 74.2 % and PG-SGA detecting 88.1 % of the overall population. Underweight patients were disproportionately affected, with MUST identifying 96.5 % and PG-SGA identifying 88.3 % as high-risk. This study emphasises the limitations of BMI alone in assessing malnutrition risk and reveals near-random agreement (κ = 0.010, p &lt; 0.001), suggesting BMI alone inadequately captures malnutrition risk in TB patients.</div></div><div><h3>Conclusion</h3><div>This study highlights a critical gap in malnutrition screening for TB patients, with MUST and PG-SGA detecting high but discordant risk levels. Given PG-SGA's higher sensitivity, policymakers in resource-limited settings should consider integrating it into TB programs for early nutritional intervention, while further research validates optimal screening approaches.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102253"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between spirituality and resilience among families with mental illness in Indonesia","authors":"Faizatur Rohmi ,&nbsp;Arik Agung Setiawan","doi":"10.1016/j.cegh.2025.102192","DOIUrl":"10.1016/j.cegh.2025.102192","url":null,"abstract":"<div><h3>Background</h3><div>Providing long-term home care for mental illness can be detrimental to the physical, mental, social, and spiritual health of the family and can impact family resilience.</div></div><div><h3>Purpose</h3><div>This study aims to identify the relationship between spirituality and resilience among families with mental illness.</div></div><div><h3>Methods</h3><div>This cross-sectional correlation study. Participants consisted of families of mentally illness patients registered with the Malang District Health Service. The inclusion criteria of the respondents, The sampling technique uses purposive sampling. Data were collected using demographic questionnaires, Spiritual Connection Questionnaire: SCQ-48, and Walsh Family Resilience Questionnaire. Pearson's correlation coefficient was applied for data analysis.</div></div><div><h3>Results</h3><div>A total of 125 families with mental illness participated in the study. Mean scores of spirituality, family resilience were 16.33 ± 4.5 and 39.89 ± 10.9. Pearson correlation showed a significant correlation between spirituality and resilience (r = 0.309, P = 0,001).</div></div><div><h3>Conclusion</h3><div>This study revealed that spirituality plays a role as a pillar in building resilience in families caring for people with mental illness, in addition this study revealed that spirituality can enhance healthy coping strategies, especially in uncertain situations when caring for patients.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102192"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of permanent contraceptive use among multiparous women in Indonesia: The role of education and other demographic factors","authors":"Maya Fitria ,&nbsp;Agung Dwi Laksono ,&nbsp;Isyatun Mardhiyah Syahri ,&nbsp;Ratna Dwi Wulandari ,&nbsp;Yuly Astuti ,&nbsp;Ratu Matahari ,&nbsp;Purwo Setiyo Nugroho","doi":"10.1016/j.cegh.2025.102280","DOIUrl":"10.1016/j.cegh.2025.102280","url":null,"abstract":"<div><h3>Problem considered</h3><div>Increased education for women, in line with their increased independence in making decisions for their good. The study analyzed the role of education and demographic factors in permanent contraceptive use among multiparous women in Indonesia.</div></div><div><h3>Methods</h3><div>This cross-sectional study examined 33,471 respondents. We used permanent contraceptives as an outcome variable and education level as an exposure variable. The study also uses nine control variables (residence, age, partner, employment, wealth, family planning (FP) information exposure from the radio, television, and the internet, and the number of living children). The study used binary logistic regression to assess the association between education level and the use of permanent contraceptives, adjusting for relevant control variables.</div></div><div><h3>Results</h3><div>The results showed that the average permanent contraceptive use among multiparous women in Indonesia is 78.7 %. Primary education was 1.747 times more likely than no formal education to use permanent contraceptives (AOR 1.747; 95 % CI 1.458–2.092). Meanwhile, secondary education was 3.295 times more likely to use permanent contraceptives than no formal education (AOR 3.295; 95 % CI 2.720–3.991). Moreover, higher education was 5.360 times more likely than no formal education to utilize permanent contraceptives (AOR 5.360; 95 % CI 4.227–6.796).</div></div><div><h3>Conclusions</h3><div>The study concluded that education level was associated with permanent contraceptive use among multiparous women in Indonesia. The higher the education level, the higher the possibility of using permanent contraceptives. Moreover, the study also found all control variables associated with permanent contraceptive use among multiparous women in Indonesia.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102280"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated factors for low modern contraceptive use and high unmet needs among postpartum women in Nepal: A cross-sectional study","authors":"Gita Shrestha,&nbsp;Minato Nakazawa","doi":"10.1016/j.cegh.2025.102281","DOIUrl":"10.1016/j.cegh.2025.102281","url":null,"abstract":"<div><h3>Problem considered</h3><div>Postpartum family planning (PPFP) plays a crucial role in reducing unintended pregnancies. However, many low-resource countries, including Nepal, have limited uptake of modern contraceptives. This study assessed PPFP use and unmet contraceptive needs among women within six months postpartum and identified factors associated with it.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study. Of the 33 healthcare facilities screened, eight met the inclusion criteria. A total of 241 women who provided consent were enrolled in the study. Descriptive analyses were conducted using Jamovi version 2.6.2.0, and multivariate logistic regression was performed in R version 4.4.2 to identify predictors of modern contraceptive use. Odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated, with statistical significance set at p &lt; 0.05.</div></div><div><h3>Result</h3><div>Logistic regression revealed key predictors of modern family planning: higher parity (OR = 2.55, 95 % CI: 1.02–6.39, p = 0.045), knowledge of ovulation (OR = 3.20, 95 % CI: 1.03–9.88, p = 0.043), and past family planning (FP) use (OR = 4.57, 95 % CI: 1.86–11.22, p &lt; 0.001) were significantly associated with modern contraceptive use. Conversely, having a last child under two years (OR = 0.49, 95 % CI: 0.25–0.98, p = 0.043) was associated with a negative outcome.</div></div><div><h3>Conclusion</h3><div>Almost two-thirds of the women wish to delay or prevent a future pregnancy, and one in six women adopted modern contraceptives within six months postpartum. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed to reduce unmet needs and improve maternal and child health outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102281"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of reproductive cancers in India: Insights from population-based cancer registries","authors":"Ranjan Kumar Prusty ,&nbsp;Varun Kumar Kashyap ,&nbsp;Mahadev Bhise ,&nbsp;Shahina Begum ,&nbsp;Sharyu Mhamane ,&nbsp;Anupama Chauhan","doi":"10.1016/j.cegh.2025.102261","DOIUrl":"10.1016/j.cegh.2025.102261","url":null,"abstract":"<div><h3>Problem considered</h3><div>Reproductive cancers (RCs) are a major component of India's non-communicable disease burden, with significant gender and regional disparities. Despite being largely preventable, early detection and access to care remain limited, and comprehensive national-level incidence data are scarce. The present study aims to provide an overview of the epidemiology of RCs in India, including their magnitude and patterns, based on data from population-based cancer registries.</div></div><div><h3>Methods</h3><div>Cancer incidence data from 37 Population-Based Cancer Registries (PBCRs) in India, covering the years 2012–2017, were analysed. RC cases were identified using ICD-10 codes. Age-standardized incidence rates (ASRs), age-specific rates, and lifetime cumulative risks were computed and disaggregated by sex and region.</div></div><div><h3>Results</h3><div>Among 436,223 total cancer cases, 61,190 (14.0 %) were RCs—15,091 in males (6.9 %) and 46,099 in females (21.3 %). In females, cervical cancer accounted for 48.8 % of RCs, followed by ovarian (28.7 %) and endometrial (15.5 %) cancers. In males, prostate cancer comprised 78.8 % of RC cases. The burden peaked between the ages of 40 and 59 years in both sexes. In India, the lifetime cumulative risk was 1 in 34 for females and 1 in 68 for males, with higher risks observed in northern and southern regions of India.</div></div><div><h3>Conclusion</h3><div>The burden of RCs in India is disproportionately higher among females, with marked regional disparities. Strengthening early detection programmes and leveraging Health and Wellness Centres under Ayushman Bharat are critical strategies. Region-specific, gender-sensitive approaches, coupled with ongoing surveillance and a multisectoral policy focus, are essential to improve outcomes and mitigate the psychosocial impacts of RCs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102261"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy, medication adherence, and diabetes complications in Morocco: A cross-sectional study","authors":"Sanaa Mohammi ,&nbsp;Nada Bennani Mechita ,&nbsp;Leila Lafdili ,&nbsp;Majdouline Obtel ,&nbsp;Rachid Razine","doi":"10.1016/j.cegh.2025.102263","DOIUrl":"10.1016/j.cegh.2025.102263","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes is a major public health challenge in Morocco. Health literacy (HL) and medication adherence are central to self-management and complication prevention, yet evidence from primary care is limited.</div></div><div><h3>Objective</h3><div>To assess functional, communicative, and critical HL among adults with diabetes in Marrakech primary care, and examine their associations with medication adherence and self-reported complications.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 333 adults with type 1 or type 2 diabetes attending urban and rural primary healthcare facilities. HL was assessed using the French Functional, Communicative, and Critical Health Literacy (FCCHL) scale, and adherence using the 8-item Morisky Medication Adherence Scale (MMAS-8). Sociodemographic and clinical data were collected through interviewer-administered questionnaires. Non-parametric tests, Spearman correlations, and multivariable linear regression examined factors associated with HL, adherence, and complications.</div></div><div><h3>Results</h3><div>Overall HL was moderate (median FCCHL 49, IQR 45–54), with critical literacy the least developed. HL did not differ by age or diabetes type but varied by education, occupation, and insurance. Three-quarters of participants had low or moderate adherence, which correlated positively with functional and critical literacy and negatively with communicative literacy. Diabetes complications were frequent (43.5 %) but showed only weak links with HL.</div></div><div><h3>Conclusion</h3><div>HL domains were differentially associated with adherence, with critical literacy showing the strongest relationship. Education and social position were key predictors of HL, whereas clinical characteristics contributed little. Primary care interventions should target functional and critical HL and adapt communication to patients’ sociodemographic profiles, while longitudinal studies clarify causal pathways linking HL, adherence, and complications.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102263"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing predictive analytics for childhood anaemia: A machine learning model approach","authors":"Baby Das ,&nbsp;Manash Pratim Barman ,&nbsp;Manas Jyoti Kotoky","doi":"10.1016/j.cegh.2025.102275","DOIUrl":"10.1016/j.cegh.2025.102275","url":null,"abstract":"<div><h3>Problem considered</h3><div>Anaemia remains a prevalent public health concern, particularly among children under five, with multifactorial causes including nutritional deficiencies, maternal health, and socioeconomic status. This study aims to enhance the prediction and understanding of childhood anaemia of Assam, India using machine learning (ML) techniques.</div></div><div><h3>Methods</h3><div>Using data from the National Family Health Survey-5 (NFHS-5) in Assam, India, a total of 8411 children were analyzed. Ten key predictors were identified using the Boruta algorithm and chi-square tests. Due to class imbalance, the dataset was balanced using Synthetic Minority Over-sampling Technique for Nominal and Continuous (SMOTE-NC). Four supervised ML models Logistic Regression, Random Forest, K-Nearest Neighbors (KNN), and Gradient Boosting were trained and evaluated using k-fold cross-validation.</div></div><div><h3>Result</h3><div>Gradient Boosting outperformed other models, achieving an accuracy of 77.2 %, precision of 79.2 %, recall of 77.2 %, F1-score of 76.7 %, and AUC value of 0.83 after balancing. Model interpretability was achieved by using an explainable AI tool i.e. SHAP (SHapley Additive exPlanations), which revealed that environmental, socio-economic and maternal factors such as roof and floor material, child's age, mother's anaemia level, and place of de-livery (Home/Public sector) significantly influenced anaemia risk.</div></div><div><h3>Conclusion</h3><div>The study demonstrates the effectiveness of ML in not only predicting anaemia with high accuracy but also uncovering actionable risk factors for public health interventions. It highlights the need for data-driven approaches in addressing childhood anaemia, especially in low-resource settings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"37 ","pages":"Article 102275"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}